The Patient Protection and Affordable Care Act

In the case of NFIB v. Sebelius (2012), there is only one major statute that is under review within the case. That statute is the PPACA passed in 2010. The act created a Federal program to create a health insurance marketplace requiring all citizens to purchase health insurance or pay a fine, which caused a debate to whether congress had the power to penalize a person if they did not purchase health insurance. This act is split into two parts: the individual mandate which in turn splits into the commerce clause and the necessary and proper clause. Then there is the medicaid expansion which revolves around the congress’s power to tax. When passed, several parties, including states, sued the government regarding the penalty that was stated within the PPACA. Though, many argued that congress didn’t have the power to put a penalty. The Supreme Court ended up siding with congress stating they did have a power to provide a penalty regarding the PPACA though the power of taxes.

The power to tax is congress’ constitutional power to levy and collect taxes which, in turn, was the main reason for the individual mandate in the PPACA to be confirmed by the Supreme Court. Though, congress tried to use the individual mandate as a means to pass the PPACA. The individual mandate is the combination of the commerce clause and the necessary and proper clause, which states that congress has the power to regulate interstate commerce or local commerce that has a substantial effect on interstate commerce. Using this method, the government tried to prove that not buying health care would cause consumption to fall which would legally allow them to penalize those who did not purchase health insurance. However, this was proven to be not applicable, but there was another way they could make the penalty a tax that will let them use their power to tax. The power to tax comes from the constitution that states that congress has the power “to levy and lay taxes”  which allows the penalty from the PPACA a new definition which was it became a tax.

The Medicaid expansion within the PPACA utilizes the Congress’ power to tax as a way to provide an expanded Medicaid system where the state government were to raise the likelihood of a person to get in the Medicaid system. However, if the state government did this, then if a person within the state did have a health care program then they would have to pay a penalty, or  a tax. The PPACA provides state governments’ with a choice of whether to receive the new Medicaid expansion and receive more federal Medicaid funds for the new law. But, if they did not agree to it, then they would lose all Medicaid funding.

Although, there was more than the loss of revenue from the expansion, there was the loss of the elderly to support themselves because the expansion made it that the elderly and those who do not meet the requirements will be covered by the states. The changes made from the Medicaid expansion were the requirements of who needed Medicare which were very few cases like pregnant women and children under six, were changed to everyone under 65 to need health care if they were below a certain percentage. The Medicaid expansion was passed within the PPACA as a policy that helped regulate the PPACA.

Leave a Reply

Your email address will not be published. Required fields are marked *